1. Aging and Disability Resource Centers “Just the Facts” Continuum of Care Across the Life Span From Pediatrics to Geriatrics September 15, 2011 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, ADMINISTRATION ON AGING, WASHINGTON DC 20201 PHONE 202.619.0724 | FAX 202.357.3523 | EMAIL aoainfo@aoa.gov | WEB www.aoa.govaoainfo@aoa.gov

2. Purpose Of the Call To better ensure a continuum of care in communities across the life span of people with special health care needs and disabilities. To maximize resources and information sharing between state programs funded by collaborating federal agencies. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, ADMINISTRATION ON AGING, WASHINGTON DC 20201 PHONE 202.619.0724 | FAX 202.357.3523 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov

3. Purpose Of the Call To learn more about ADRCs, their networks and services and how the F2F HICs can partner with them. To look at the benefits of collaboration: what the ADRCs and the F2F HICs can do to help each other. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, ADMINISTRATION ON AGING, WASHINGTON DC 20201 PHONE 202.619.0724 | FAX 202.357.3523 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov

4. National Vision for ADRCs To have Aging and Disability Resource Centers in every community serving as highly visible and trusted places where people of all incomes and ages can turn for information on the full range of long- term support options and a single point of entry for access to public long-term support programs and benefits. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, ADMINISTRATION ON AGING, WASHINGTON DC 20201 PHONE 202.619.0724 | FAX 202.357.3523 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov

5. Defining Characteristics of an ADRC U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724 | FAX 202.357.3555 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov All populations and income levels served Seamless system from consumer perspective Integration of/coordination across aging, disability, Medicaid service systems Formal partnerships High level of visibility and trust Options counseling Proactive intervention into LTSS pathways More a process than an entity

6. Maturity, Growth, and Expansion of ADRCs U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724 | FAX 202.357.3555 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov AoA and CMS view ADRCs as the platform to: Catalyze broader systems change Promote participant-direction Build stronger partnerships across siloed LTSS system Intervene during care transitions from hospitals and other acute care settings Assist with institutional transitions Implement new initiatives (e.g., Veteran Directed Home and Community Based Services)

7. Findings from Eight Years of ADRC Experience U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724 | FAX 202.357.3555 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov Progress Towards the National Vision for Fully Functional ADRCs Models and Partnerships Coverage Service trends Sustainability Impact

8. Every Community? ADRC Coverage June 2011 25-50% of state population Hawaii Alaska MT ID WA CO WY NV CA NM AZ MN KS TX IA WI IL KY TN IN OH MI ALMS AR LA FL SC WV VA NC PA VT RI ME NH OR UT SD ND MO OK NE NY CT MA DC DE Guam Northern Mariana Islands 1-25% of state population 100% of state population 75-99% of state population 0% of state population GA 50-75% of state population Puerto Rico MD

9. Model and Operating Organizations (SART April 2011) 46% of ADRCs are operated by more than 1 organization 82% include an AAA as one operating organization, 25% include a Center for Independent Living

10. Formal Partnerships? (SART April 2011) What is a Formal Partnership? Funded to perform ADRC Services Co-location Memorandum of Understanding (MOU) Contract Written Protocols Cross-Training What do ADRCs Report? Average of 14 formal partnerships with Individual Organizations reported at program/local level ADRCs partner with average of: – 14 different types of organizations at state level – 12 different types at program/local level U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724 | FAX 202.357.3555 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov

11. Highly Visible and Trusted? Contacts to ADRCs (SARTs 2004-2010) Semi-Annual Reporting Time Period Total Number of Contacts Total Number of Contacts per Month Average Contacts per Month per 1,000 Residents in Service Area Number of Program Sites Reporting Oct. 2004 – March 2005182,11628,7992.831 April 2005 – Sept. 2005311,39854,4942.846 Oct. 2005 – March 2006454,06176,5783.158 April 2006 – Sept. 2006372,48262,8252.566 Oct. 2006 – March 2007483,57396,3243.191 April 2007 – Sept. 2007634,535106,4002.890 Oct. 2007 – March 2008702,660119,6262.9107 April 2008 – Sept. 2008713,730118,9552.9128 Oct. 2008 – March 2009993,740165,6233.6125 April 2009 – Sept. 20091,140,167331,3863.9131 Oct. 2009 – March 20101,387,181241,0813.9194 April 2010 – Sept. 20101,866,019321,1894.7247

12. Fully Functional? Percent of States with “Fully- Functional ADRCs” by Domain Information, Referral, and Awareness37% Options Counseling and Assistance25% Streamlined Eligibility Determination for Public Programs40% Person-Centered Transition Support33% Target Populations and Partnerships71% Quality Assurance17% 15 States Fully Functional Across All Domains in 2010 - Compared with 10 in 2008

13. Sustainable? Annual ADRC Budget Revenue Sources (SART October 2010)

14. Hawaii * Alaska * MT ID* WA † CO † WY NV CA *† NM AZ MN TX † KS * IA WI IL † KY TN † IN † OH MI ALMS AR LA FL † SC * WV VA NC* PA † VT RI † NH † OR * UT SD ND MO * OK NE NY † CT † MA † DC Care Transitions Activities DE Guam Northern Mariana Islands 34 States with ADRC program sites currently conducting care transitions through formal intervention 11 States with ADRC program sites currently planning to conduct care transitions through formal intervention GA 9 States not reporting current or planned care transition activities Puerto Rico MD *† NJ ME †

15. Impact? The Big Question ADRCs report high levels of consumer satisfaction with responsiveness, objectivity, comprehensiveness of information and assistance Much less known about long term impact on quality of life, satisfaction with decisions made as a result of options counseling – Options counseling standards grants should produce more information – National Evaluation by IMPAQ, Int. in design phase, findings expected 2013 Diversion and Rebalancing? – Some indication of correlation between extent of ADRC coverage within a state and greater HCBS to Institutional spending ratios – The Lewin Group analysis 2010

16. Rising Expectations: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities and Family Caregivers* The Scorecard finds that generally states with the highest level of performance have enacted public policies designed to: Improve access to services and choices in their delivery by directing state Medicaid programs to serve more people in need and offer alternatives to nursing homes that most consumers prefer. Establish a single point of system entry to help people find needed information and more easily access services. Improve support for family caregivers by offering legal protections as well as other services to address caregiver needs.” *AARP, The Commonwealth Fund & the Scan Foundation September 2011

17. Take-Away Messages and Lessons Learned Significant progress has been made, but more work to do ADRCs can serve as catalysts for other LTSS rebalancing efforts Success depends on how well ADRCs are integrated into other LTSS reform efforts ADRC is more a process than an entity The 4 Ps: Partnership, person-centered focus, planning and patience

18. Examples of Collaboration South Carolina Nevada

19. South Carolina F2FHIC and ADRC/AAA/LGOA Collaboration A work in progress

20. Aging and F2F System in SC Aging and Disability Resource Centers (ADRC) – 10 regional ADRC’s located at AAAs – Focus on older adults and adults with disabilities – Serving families with children F2F HIC – Central 1-800# at Family Connection of SC – Trained Family Partners across the state – Focus – families with children age 0-21 with special health care needs

21. ADRC and F2F Collaboration Historical – First ADRC had a Family Partner co-located at the AAA/ADRC Current – Driven by funding through the AoA funded Lifespan Respite Grant – Cross-training – Conference support – Referrals to each other – Documentation of referrals – Local “Meet and Greets” discussed

22. Coordinate Information, Referral and Assistance Family to Family Health Care Information and Education Center Aging & Disability Resource Centers Provide outreach, information and screening for respite services Connect families to respite early in the process

23. Benefits of Coordination Shared expertise Increased understanding of services Resource for ADRCs serving “grandparents raising grandchildren Resource for “sandwiched” families having child with disabilities/special health needs and aging parents

24. Family TIES of Nevada Rebuilding All Goals Efficiently (RAGE) Family TIES of Nevada is the Statewide Family to Family Health Information Center RAGE is the Southern Nevada Aging and Disability Resource Center

25. BACKGROUND F2F HIC - Established in 2001, Family TIES of Nevada is dedicated to increasing the hope, confidence and independence of people with disabilities and chronic health conditions of all ages and their circle of support through training, information, emotional support and advocacy. ADRC - Established in 2005, Rebuilding All Goals Efficiently (RAGE) is committed to mentoring and assisting the senior and/or disabled consumer to achieve a higher quality of life by empowering them to judge, direct, and manage the services they need. We counsel the consumer about being self- reliant and we facilitate their efforts to achieve self sufficiency and independence in the home and community. Family TIES and RAGE assess and identify individual’s wants and needs and provide them with information and assistance. The ADRC serves as the entryway that connects consumers to an array of public and private pay long-term supportive services. The F2F HIC helps families find and navigate community services for their children with special health care needs.

26. Collaboration Projects Our programs work together through a referral process when consumers need assistance for other types of resources and supports Resource Sharing at Health, Education & Community Events Job Development Assistance to Youth with Special Health Needs through the VISTA Program and School Outreach Autism Financial Program Nevada Check Up and Medicaid Application Assistance Workshop Coming Soon!

27. Presenters Nevada ADRC Reggie Bennett, Executive Director Rebuilding All Goals Efficiently (RAGE) Reggie@bteamrage.org www.bteamrage.org (877) 785-RAGE - Toll Free Nevada F2F HIC Melanie Kauffman, Executive Director Family TIES of Nevada mkauffman@familytiesnv.org www.familytiesnv.org 866-326-8437 – Toll Free

28. Shared Interests Improved access to services Systems changes/seamless systems Family partnerships/caregivers Information and referral

29. DISCUSSION

30. FOR MORE INFORMATION: WWW.AOA.GOV TECHNICAL ASSISTANCE EXCHANGE: WWW.ADRC-TAE.ORG FIND AN ADRC SEE STATE ADRC PROFILES WWW.AOA.GOV WWW.ADRC-TAE.ORG FIND AN ADRC SEE STATE ADRC PROFILES Elizabeth Leef Program officer, Administration on Aging 202-357-3444 Elizabeth.leef@aoa.hhs.gov U.S. Department of Health and Human Services, Administration on Aging, Washington DC 20201 PHONE 202.619.0724 | FAX 202.357.3555 | EMAIL aoainfo@aoa.gov | WEB www.aoa.gov